alpha-receptor blockade for benign prostatic hyperplasia: uses and problems in a developing country

To evaluate the use and problems of alpha-receptor blockade with prazosin among patients in Nigeria with benign prostatic hyperplasia (BPH) who face a prolonged wait for a prostatectomy.

The study comprised 31 patients (mean age 64.4 years, range 55-89) facing a prolonged wait for prostatectomy: in group 1, 14 patients presented in acute urinary retention and had an indwelling urethral catheter; in group 2, six patients had indwelling catheters but removal was deemed necessary to control urinary tract infection: in group 3, 11 patients had troublesome symptoms from BPH but no retention. Some of the patients were also hypertensive. After receiving I mg of prazosin twice daily, the catheters were removed at various intervals and the effect on symptom scores and residual urine volume determined after one week and 2 months.

Prazosin allowed the catheters to be removed, improved the symptoms of prostatism and/or controlled high blood pressure in seven, five and nine patients in each group, respectively.

The use of this alpha blocker for BPH in the absence of facilities to measure urinary flow rate, intravesical pressure and serum prostate specific antigen can be justified for short periods. However, a large default rate among these patients raises additional questions about long-term safety and underlines the importance of selecting patients carefully.